Endurance nutrition for GI distress prevention -
Keep in mind that sodas, salt, and maltodextrin-rich products are heavily present at many races. Thus it is important to select food at the aid station consciously! A quick drink of soda will deliver caffeine and sugar to your system and provide a quick energy kick.
But the sugar-laden soda will inevitably lead to GI issues thanks to the concentrated shot of sugar being released quickly into the GI system. In some cases, avoiding products rich in sugar and salt may not be sufficient to limit digestive system problems.
Food additives and preservatives have been shown to trigger stomach pain and increased sensitivity. Avoiding preserved foods while running is a good idea anyway as some preservatives sodium benzoate or sulfates , even though not considered toxic, may affect mitochondrial functions.
We train to improve mitochondrial functions. There is nothing more counterproductive than voluntarily ingesting substances that undermine training effects! Spring Energy products are designed with the knowledge that GI distress is one of the leading problems in endurance sports nutrition.
By using various sources of energy, lowering sugar content, including fat and excluding preservatives, we were able to overcome this problem. Go ahead, read the nutritional content on the back of a Spring gel or on our site. Spring Energy can be your weapon against GI distress!
Endurance athletes have been known to manipulate specific food components in their diets to reduce Ex-GIS, such as gluten-free 25 , 26 or low fermentable oligosaccharide disaccharide monosaccharide and polyols FODMAP diets 25 , 27 , Laboratory studies have shown that when endurance athletes consume a short-term gluten-free diet, there was no difference in performance, gastrointestinal symptoms, or intestinal injury compared to the gluten-containing diet In contrast, preliminary research indicates a low FODMAP diet 24 h before endurance exercise in the heat results in less Ex-GIS and malabsorption compared to a high FODMAP diet.
However, a novel finding of that study is that the high FODMAP diet ameliorated intestinal epithelial injury Further research is required in this area to determine the significance of this finding. Other dietary factors which may reduce Ex-GIS are the types and amounts of macronutrients consumed during endurance exercise.
Research has shown that when 15 g of carbohydrate or whey protein hydrolysate is consumed pre-exercise and every 20 min while running i. However, endurance athletes reported fewer Ex-GIS in the carbohydrate group, which suggests protein is less well tolerated during endurance exercise 5 , In addition to dietary factors, maintaining euhydration before 32 and during endurance exercise has been shown to reduce Ex-GIS and improve gastrointestinal integrity and function compared to dehydrated controls Athletes may also seek non-dietary factors e.
Many factors may influence Ex-GIS development; therefore, athletes may often seek different ways of managing the incidence and severity of Ex-GIS.
Due to their nutrition expertise, it is possible that accredited practicing dietitians are a preferred source of nutrition information for athletes.
However, this likely depends on accessibility and background, i. Interestingly, social media, team-mates, or other athletes also appear to be popular information sources for athletes 35 — 37 , possibly due to the convenience and ease of access to these sources.
Less is known about the preferred information sources for athletes who report Ex-GIS, as it often involves dietary and non-dietary management 5 , The primary aim of the current research was to investigate self-selected dietary and non-dietary strategies endurance athletes use to manage Ex-GIS and their preferred source of information about these strategies.
This exploratory study used a previously established validated online questionnaire to investigate self-reported Ex-GIS, management strategies, and information sources Athletes were recruited internationally through professional and academic networks.
All responses collected were anonymous. This study was approved by the Human Research Ethics Committee University of the Sunshine Coast, Australia , ethics approval number S and conformed to the Helsinki Declaration for Human Research Ethics.
The questionnaire included participant information e. The questionnaire included 43 items depending on dichotomous, Likert scales, or descriptive responses 38 Supplementary material 1. Retrospectively, athletes selected when they experienced Ex-GIS the most frequently, either around training AT or around competitions AC or equally around both training and competitions.
Athletes indicating Ex-GIS equally around both training and competitions completed both training and competition-specific questions, which were categorized as equally training ET and equally competition EC. Athletes then responded to questions on when Ex-GIS occurred i.
A validated modified visual analog scale symptomology assessment tool was used for determining the incidence and severity of Ex-GIS in response to exercise stress The symptom severity scale was from 0 to 10; 0 no symptoms, 1—4 mild symptoms i.
Athletes selected the severity of each symptom from 0 to 10 whereby the incidence was. Athletes completed open-field response questions on dietary and non-dietary strategies tried to reduce Ex-GIS. A content review process was applied for all qualitative data, categorizing and coding responses into the most common dietary and non-dietary themes The themes were the five most common dietary strategies to reduce Ex-GIS around exercise, specific high FODMAP food group exclusion, and the non-dietary strategies used to manage Ex-GIS.
From pre-defined lists, athletes selected the most successful dietary components e. Athletes who experienced Ex-GIS equally in training and competitions completed both training and competition Ex-GIS severity questions, i.
Therefore, four groups were used for data analysis, i. Repeated measures were also applied within each symptom category, i. The incidence was calculated as the number of athletes responding to each symptom in each group, and the severity was calculated as the average response to each symptom.
Descriptive statistics were used to define continuous variables means, standard deviations, and percentages , and for non-parametric data, medians and interquartile ranges IQR were applied.
Chi-squared tests were used to determine associations between categorical data, i. For any significant group differences, Bonferroni post hoc tests were used. For Ex-GIS incidence and severity, the data were checked for normality by applying the Shapiro—Wilk test.
The Friedman test was used to determine differences within each symptom group, and a post hoc Wilcoxon test to determine differences within repeated measures. A Bonferroni correction factor was applied if significant. Data analysis was performed using IBM SPSS Statistics One hundred and thirty-seven endurance athletes with Ex-GIS completed the questionnaire.
The mean age was Participant characteristics are described in Table 1 , and Ex-GIS incidence in Table 2. There were no differences in Ex-GIS incidence by main sport, participation level, or biological sex.
Table 1. Table 2. Figure 1 highlights the combined incidence for each Ex-GIS and the median severity of all symptoms across all independent groups.
Lower-GIS was more commonly reported compared to upper-GIS in all groups, i. Figure 1. Combined incidence and median severity rating of gastrointestinal symptoms before, during, and after exercise. Symptoms are listed in upper, lower, and other symptom categories and descending order of incidence.
A Ex-GIS around training only, B Ex-GIS around competitions only, C Ex-GIS equally around training and competitions training responses. D Ex-GIS equally around training and competitions competition responses. B, Belching; BL, Bloating; D, Dizziness; DB, Defecation Bloody Stools; DD, Defecation Diarrhea ; DL, Defecation Loose Stools; F, Flatulence; Ex-GIS, exercise-associated gastrointestinal symptoms; HB, Heartburn; LA, Lower Abdominal Bloating; LI, Left Intestinal Pain; N, Nausea; PV, Projectile Vomiting; R, Regurgitate; S, Stitch; SP, Stomach Pain; UD, Urge to Defecate; UR, Urge to Regurgitate.
The incidence and severity of symptoms were not normally distributed; therefore, median and IQR were used to describe the data with non-parametric tests applied.
Using the Wilcoxon test for non-parametric data the incidence of reported symptoms was significantly greater during exercise than before and after exercise e. Table 3. A total of strategies were reported by athletes, an average of 3. A qualitative content review of the strategies used including the five most common dietary strategies to reduce Ex-GIS, specific high FODMAP food groups exclusion, and the non-dietary strategies used to reduce Ex-GIS, are shown in Figure 2.
The most popular dietary strategies were dietary fiber reduction Avoiding disaccharides lactose and sucrose 6. Figure 2. FODMAP, fermentable oligosaccharide disaccharide monosaccharide and polyols; GOS, galacto-oligosaccharides; FOS, fructo-oligosaccharide.
Endurance athletes rated the overall success of specific dietary components Table 4 or attempted dietary strategies Table 5 and when they tended to implement them. Table 4. Dietary components self-selected to eat more or less of to reduce the development of exercise-associated gastrointestinal symptoms.
Table 5. Specific dietary strategies trialed, and supplements used to reduce the development of exercise-associated gastrointestinal symptoms listed in order of success at reducing symptoms. The most common sources of dietary information for Ex-GIS management are shown in Figure 3.
After chi-squared analysis and post hoc testing, no significant associations were found between the most important nutrition information sources for managing Ex-GIS, categorized by main sports, participation levels, event characteristics, or biological sex.
Figure 3. APD, Accredited Practicing Dietitian. This is the first exploratory study to review the specific self-reported strategies used to manage symptomology amongst endurance athletes who experience Ex-GIS. The most commonly reported successful dietary strategies to manage Ex-GIS, typically before and during exercise, were dietary fiber reduction, a low FODMAP diet, a dairy-free diet, and increasing carbohydrates.
Endurance athletes primarily sought accredited practicing dietitians in the management of Ex-GIS. Reducing dietary fiber, particularly before exercise, was the most common dietary strategy endurance athletes have implemented.
Current sports nutrition guidelines recommend endurance athletes reduce dietary fiber around key training sessions and competitions to mitigate the incidence of Ex-GIS 3 , 29 , This is due to the ability of dietary fiber to increase the luminal contents in the large colon due to an osmotic effect and fermentation, which may promote greater gastrointestinal discomfort and reduced orocaecal transit times 5 , 7.
However, due to variable gastrointestinal tract transit times, a low-fiber diet may require implementation 1—3 days before exercise 41 , which may not be practical habitually. Therefore, if athletes restrict dietary fiber to reduce Ex-GIS, a short-term low-fiber diet around specific competitions is likely to be practical without compromising the beneficial effects of consuming adequate dietary fiber daily.
Ex-GIS reported by athletes in this investigation was similar to individuals diagnosed with IBS, including abdominal pain, bloating, and diarrhea An effective treatment strategy for those with IBS is implementing a low FODMAP diet 43 , Similarly, athletes commonly reported using a low FODMAP diet to manage Ex-GIS successfully in the current study.
A low FODMAP diet has also reportedly been used to manage Ex-GIS in other investigations with athletes 25 , However, the time frame for implementation in previous studies, including the current study, has not been investigated.
It has been shown that a short-term h low FODMAP diet before endurance exercise can reduce Ex-GIS and malabsorption 10 , and the impact of this short-term dietary restriction on overall nutritional status is unlikely to be significant.
However, a low FODMAP diet is not designed to be followed long-term due to possible nutritional deficiencies if chronically administered 43 , However, if a low FODMAP diet is necessary over more extended time frames i.
Dairy avoidance around exercise was an exclusive dietary strategy employed by athletes to reduce Ex-GIS, i. In this study, dairy products were avoided before, during, and after exercise.
Endurance athletes may have been avoiding dairy products due to the lactose component, which is typically moderated on a low FODMAP diet It is possible that endurance athletes avoid dairy as they have lactose intolerance.
Lactose intolerance is one of the most commonly reported food intolerances, with many symptoms overlapping with IBS, e. In the current study, implementing a lactose-free diet was also reported as a successful dietary strategy to manage Ex-GIS; however, slightly lower implementation rates before, during, and after exercise were reported compared to a dairy-free diet.
Future research could also investigate if athletes have food allergies or intolerances, hence the need for a dairy or lactose-free diet. Many endurance athletes also reported successfully increasing carbohydrate around endurance exercise to mitigate Ex-GIS development.
Increasing carbohydrate intake around exercise is a well-advocated dietary method to facilitate carbohydrate availability, particularly for endurance and ultra-endurance athletes 3 , 29 , However, research has also shown that carbohydrate consumed during exercise facilitates splanchnic region blood flow It is possible this also promotes intestinal epithelial blood flow, reducing epithelium damage.
To overcome both the risk of GI distress or hyponatremia: drink enough fluid to slow dehydration and not necessarily prevent it. Continuous sipping is recommended, or else hydrating with small volumes every 20 — 30 minutes, or better yet, drink according to thirst. The speed at which a beverage travels from the stomach in to the small intestine the gastric emptying rate depends on the energy content calories and volume of the beverage consumed.
A small concentration of carbohydrate will encourage rapid absorption, but too much carbohydrate will slow gastric emptying and can result in GI distress. Sports drinks are scientifically formulated for optimal gastric emptying. Furthermore, sports drinks also aid in replenishing glycogen stores in working muscles, as well as electrolyte balancing and replenishment and are therefore valuable hydration options.
The concentration and the type of carbohydrates in a sports drink however, require some consideration. There appears to be no major difference between glucose, sucrose, maltodextrins, fructose and starch on athletic performance itself.
Fructose, however, has a slower absorption rate, and in large quantities, is likely to cause GI distress than any of the other carbohydrate s.
Fructose is sweeter than maltodextrins and is often used to make the drink appealing. Maltodextrins remove the unpalatable sweetness, and sucrose is absorbed more rapidly than fructose. Thus read labels carefully, look for a combination of these carbohydrates.
Carbohydrates regardless of whether solid or liquid will aid in athletic performance, but consider drinking them rather than eating them, since the fluid takes care of two very important performance issues: hydration and energy.
Stomach and intestinal distress tend to increase during high-intensity training. Stomach fullness is also directly related to gastrointestinal discomfort levels during intense sporting activity.
Different intensities also result in different carbohydrate utilization.
Endurance nutrition for GI distress prevention to content. Training Tips Nurrition. You may be Hypoglycemia and cognitive function the top of your physical game, preevention your peak Endurane level, but if GI distress crops up on race day, it can be a show stopper. Numerous factors including diet, stress, hydration, and effort-intensity are responsible for GI problems during physical activity. Some of which are preventable.Video
Number ONE Cause of Chronic Fatigue: 50 Years or Older Belly fat burner belt exploratory study investigated endurance athletes self-reported exercise-associated preventipn symptoms Ex-GIS and associated fo to manage Endurance nutrition for GI distress prevention. Athletes prrevention when Endurance nutrition for GI distress prevention developed most frequently either around training Endhrancearound competitions ACor equally around both training ET and competitions EC. Athletes reported the severity of each symptom before, during, and after exercise. The Friedman test and post hoc analysis with Wilcoxon signed rank test was conducted with a Bonferroni correction applied to determine differences between repeated measures. Ex-GIS incidence was significantly higher during training and competitions in all categories. In contrast, non-dietary strategies included the use of medications 4. Endurance athletes use a variety of strategies to manage their Ex-GIS, with dietary manipulation being the most common.
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